STAR*D: The Third Drug’s the Charm

New results from STAR*D indicate that switching to a third antidepressant can, in certain cases, lead to remission for patients who have failed 2 prior antidepressants. Following treatment failure, 235 adults were randomly assigned to a third antidepressant regimen of either nortriptyline or mirtazapine. After 14 weeks, exit scores were assessed via the HamD₁₇. HamD₁₇ remission rates for nortriptyline and mirtazapine were 12.3% and 19.8% respectively, however the difference in response rate for the two substances was not statistically significant. The authors of the study, appearing in the American Journal of Psychiatry, concluded that switching to a third antidepressant results in significant, but low, remission rates. http://ajp.psychiatryonline.org/cgi/content/abstract/163/7/1161